Picking up pancreatic cancer
Joseph is 59-year-old accountant who presents with constipation and a mildly reduced appetite.
He discloses a six-month history of progressive constipation and has been self-managing by using a stool softener and laxatives.
He believes his constipation is due to a hectic work schedule meaning he has a daily takeaway with very limited fresh vegetable intake.
The laxatives do help initially, but later he reports having severe constipation requiring over-the-counter fleet enemas.
Joseph requests a more aggressive